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General NPI Number Information
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NPI Number | 1043161979
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Entity Type | Organization
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Legal Business Name | 4 HEALTH
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1045 ELM ST STE 204 OFFICE 504
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City | MANCHESTER
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State | NH
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Zip | 03101
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Country | US
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Telephone | 917-579-5441
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 ELM ST STE 204
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City | MANCHESTER
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State | NH
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Zip | 03101-1844
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Country | US
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Telephone | 917-579-5441
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | LANCE TREVOR DIAMOND
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Credential |
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Telephone | 917-579-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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